Andrews, W.(Department of Pediatrics, Memorial University of Newfoundland, Canada)Simmons, B.(Department of Pediatrics, Memorial University of Newfoundland, Canada)Aziz, K.(Department of Pediatrics, Memorial University of Newfoundland, Canada)Friel, J.(Department of Biochemistry, Memorial University of Newfoundland, Canada)

ECMO is a technique of providing cardiopulmonary bypass to newborn infants with
severe but potentially reversible pulmonary failure.While it has been in use for 20
years, there have persistent discussion on whether there was enough evidence to
justify its widespread use. Even with the publication of a recent large randomized trial
of ECMO from the UK,the is still commentry on the ethics of this trial (Paed. Perinatal
Epidemiology July 1997). The purpose of abstract is to review systematically and
cumulatively the effect of ECMO on infant deaths in the four published randomized
trials.The studies are:Bartlett et al 1985 Pediatrics, O'Rourke et al
1989, Pediatrics, Gross et al 1994 Ped. Research and Uk Collaborative
1996, Lancet. The studies are of varying quality with small sample size, differing
randomizaton methods and the difficulty of masking the intervention. Despite the
differing quality, all four studies were included in the analysis. Only infants entering the
study by randomization were included the analysis. With some studies having no deaths in the
ECMO group,to aid in the calculations of relative risks, a correction factor of .5 was
added to each cell in all studies. A logarithm of the RR method and a fixed effects
model is used. This systematic review suggests that only with the completion of the large UK
study was a high level of statistical signifcance obtained. The cumulative analysis suggest that
statistical signifance was obtained after the third study, although this study was
published only as a preliminary communication.

Back to the top.Poster Number PAandrews0295Keywords:ECMO, systematic, review, newborns